And Then There was My Army Grunt (Second of Three Breastfeeding Stories)

My second child came the night that I decided that I was probably never going to go into labor and that I was going to reabsorb the baby. He was two days overdue and instead of feeling “close” to giving birth I felt that we would go another couple of weeks easily. Something that I didn’t relish the prospect of, as my care provider was zealous about inducing at 41 weeks.

Three hours after the first contractions he was born into the hands of the flustered resident that leaped over the birthing bed, briefly considered breaking the bed down as she had been trained to do, and reconsidered as this second child of mine had his own timeline firmly established. The doctor that they had paged was never able to make it.

His older brother had looked like a baby dragon, but A. looked like an army grunt. Close cropped hair with a widow’s peak that looked like someone had given him a buzz cut. He was minutes old and had an air about him that radiated a mellow oomph.

This child of mine settled down to nurse immediately as though he had gone through basic training. He had the rhythm, the confidence, the latch, the persistence. I used lanolin once to help the chapping that came from his frequent nursing.

He gained rapidly for the first three months, and then his weight gain tanked. Slowly he sunk through the percentiles. I was caught between opposing camps. The camp that believed that there was some deficiency with my breastmilk, a school of thought that confused me because the milk that I pumped was mostly fat. My son made around 20 diapers a day and we had recently switched to cloth because the disposables would have easily bankrupted us. And the other school of thought that said he was perfectly fine because his diaper count was good and he was meeting milestones.

Caught in the middle I didn’t feel that either answer was right. There was something that was off. I couldn’t put my finger on it.

As it turned out, this little guy was severely tongue tied. Diagnosing a tongue tie has become a bit of a lost art and it is not widely understood that the tongue has many types of movement necessary for a baby to nurse effectively. The “one step” test of “can the tip of the tongue extend over the lower lip” is a terrible test.

Once the tongue tie was clipped, all of the little issues disappeared and my little army grunt rose back to where he was supposed to be in the percentiles.

Ironically, of my three children the one with a severe tongue tie was the “best” nurser from the start.

Breastfeeding him was easy from the beginning. He had clear cues. He’d nurse until he was done and then he’d want a pacifier despite not having been given one before six weeks. He liked to be rocked, to be held,  to be worn. He liked to sleep in his own bed and didn’t wake often in the night in those first few months although as his weight gain dropped he would wake more and more frequently and developed issues that mirrored reflux.

Despite the easiness of breastfeeding it always felt different from nursing my first. There was something missing. Nursing was simply feeding with none of the hormone rushes that I had come to associate with breastfeeding. I dismissed it as “every child is different”. I had never been big on the idea that breastfeeding was bonding anyway.

As it turned out these things were all caused by the tongue tie. A simple snip and fifteen seconds of crying at eight months old fixed everything that was “broken”, and a few minutes later we were nursing for what felt like the first time.

A. went on to wean himself at eighteen months old, four months before his sister was born. He remains delighted to get mommy milk in a cup, although he’s still a grazer and will drink an ounce or so before he pours the rest onto the floor. Kid’s got his own ideas about how things are done.

  3 comments for “And Then There was My Army Grunt (Second of Three Breastfeeding Stories)

  1. Diana
    January 14, 2014 at 4:18 am

    Hi, Thank you so much for sharing your breastfeeding stories. I’m a first time mom and suspect that my son has a lip tie. This is because although we are nursing on demand at home, his weight gain is slow and he is severely underweight based on every chart I looked at. I find it difficult to find a physician who knows how to make a proper diagnosis in support of breastfeeding. How did you verify that your son has a lip tie? Thanks.

    • sarah
      January 14, 2014 at 10:09 am

      Diana,

      I brought my son to a pediatric Ear-Nose-Throat (ENT) specialist that was a known breastfeeding supporter and that had experience with posterior (type 3/4) tongue ties. A pedi ENT specialist with knowledge of that type of tongue tie tends to be more knowledgeable and familiar with the types of lip and tongue ties that interfere with breastfeeding.

      A simple (maybe too simple) test for lip tie and if it interferes with breastfeeding is this- pull your child’s lip back. If you see a thick band of skin connecting the lip to the gums, that’s the frenulum. If you see “pockets” on either side of the band of skin and if the band of skin becomes very tight and turns white when you pull the lip back, that’s a lip tie. It restricts the movement of the lip and creates a shallow ineffective latch for some babies.

      If the band of skin is loose, doesn’t form a “fence” or pockets, then it’s generally not a problem for breastfeeding or will stretch itself out as your child gets older.

      Tongue and lip ties tend to come together so if your LO has a lip tie chances are he also has a tongue tie. Posterior tongue ties can be hidden because they don’t make the little “heart” shape that doctors look for and there is not always an obvious frenulum under the tongue. A posterior tongue tie may allow the baby to extend their tongue over their lower gum but may restrict the other movements that a tongue needs to be able to make in order to nurse effectively. (A tongue must extend over the lower gum, curve to cup the breast, and move up/down and forwards/backwards to get milk out and to transport the milk to the back of baby’s mouth for swallowing. If baby’s tongue has restricted movement they may be chewing instead of nursing.

      Is your baby “small” or is your baby just gaining weight along a different curve? You want to see 4-8oz/week gain for a breastfed baby. Some doctors and charts will look at a baby that was born small and expect them to be gaining at a “catch up” pace rather than just following their own curve. Or they will see a week where baby gained 3 ounces and ignore that some other weeks they gained more. Some babies are naturally small/petite.

      If baby’s tongue/lip are not the culprit and baby is making enough wet diapers per day then baby may have a sensitivity to something in your diet (milk/soy are common culprits) and an elimination diet may help you get baby back on track. :) A visit to a pediatric GI specialist may be helpful if you suspect food sensitivities.

      You can help your baby out by doing breast compressions while nursing. This can help an ineffective nurser get more hindmilk. You can also use a supplemental nursing system to offer pumped milk while breastfeeding if you suspect that your LO is having a hard time because of a tongue tie. (My middle child would gag and vomit with bottles- which was also an issue related to his tongue tie.)

  2. Michele
    October 9, 2014 at 2:17 pm

    Hello,

    Did you have any supply issues after such a long feeding restriction from tongue tie? We just went through a similar story with our daughter who was finally diagnosed and treated for tongue tie at 6 months. (In addition to being tagged as “happy to starve”. She got low enough in the charts that we have a feeding specialist appointment in two weeks where they should evaluate her lip tie too.) I feel like I am now struggling with insufficient milk for her now that she is learning how much food she really needs. I know it will take a little while for us to readjust to each other, and most days I have been able to enough to supplement at her fussiest times. Unfortunately, the Lactation Consultant that diagnosed the tongue tie also planted the idea that having been so long, the only way my supply will get where it needs to be is with domperidone which I would like to avoid.

    Most of what I have been able to find about building supply has been around much younger babies, so I am looking for references and stories about doing it further down the road.

    Thank you. Reading my way through your site has filled and reassured many late night nursing sessions.

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